Abstract
Introduction
Dissatisfaction with the posterior approach to total hip replacement has led to the anterior approach being adopted with enthusiasm in some areas.
Objectives
We aim to assess any difference between the 2 approaches and if so, the magnitude of this difference.
Methods
This is a sequential case series of 100 anterior and 100 posterior approach hip replacements. It comprised 98 and 94 patients respectively. Clinical outcome scores of SF36, WOMAC, Harris Hip and Tegner activity score were analysed pre-operatively, 6, 12, 24, 36, 48 and 60 month intervals.
Results
The anterior was significantly better(p<0.05) in SF36 Total and Physical scores at 6, and 12 months and in the SF36 Physical at 24 months. Significant differences (p<0.05) were present for WOMAC Total scores at 6 and 12 months. Tegner outcomes at 6 and 12 months had a significant difference (p<0.05). Harris Hip significant differences (p<0.05) were shown at 6, 12, 24, 36 months. The posterior approach was not significantly better than the anterior in any of the measurements.
Conclusion
Different measuring instruments have different focuses. It was noted that the posterior approach was not superior at any stage. The most significant difference was seen in the Harris hip score, were a statistically significant difference was noted up to 36 months post operatively.
